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Cuts to Medicaid Programs Avoided Due to ADA Compliance Issues

January 26, 2012

Separate court proceedings in California and Louisiana last week upheld the right of elders and people with disabilities to receive care in their homes under the Americans with Disabilities Act (ADA).

In California, federal judge Claudia Wilken issued a preliminary injunction on Jan. 19 blocking the state from enacting a 20 percent cut to the In-Home Supportive Services (IHSS) program, which provides care to nearly 450,000 elders and people with disabilities who have Medicaid.

The cuts were initially scheduled to take place on Jan. 1, but were temporarily halted by Wilken last December due to concerns that they violated the ADA. Wilken reiterated those concerns in her latest injunction.

If ever enacted, the IHSS budget cut would cause 372,000 IHSS consumers to see reductions in home care services, possibly forcing them into nursing homes or other institutions — a violation of the ADA. In 1999, the Supreme Court ruled that the ADA gives seniors and people with disabilities the right to live at home if their care needs can be reasonably met there.

“Judge Wilken has consistently recognized how crucial IHSS is for people with disabilities in California,” said Donna Calame, the executive director of the San Francisco IHSS Public Authority and a PHI board member.

“Her ruling was terrific for both technical legal reasons and because it continues, for the time being, the current level of service hours to people who live in borderline poverty situations — both consumers and the workers who assist them,” Calame added.

The state plans to appeal Wilken’s decision to the Ninth Circuit Court of Appeals. Last month the Ninth Circuit ruled that Washington State had violated the ADA by cutting its Medicaid in-home care program by 10 percent.

Louisiana Lawsuit Settled

Meanwhile, in Louisiana, advocates for elders and people with disabilities reached a settlement with the state over a reduction in-home care services there.

Advocacy Center and AARP Foundation Litigation advocates had filed a class action lawsuit in September 2010, arguing that the state was violating the ADA by imposing a 32-hour weekly cap on consumers enrolled in the state’s Medicaid in-home services program.

As part of the settlement (pdf), state officials will request 200 waivers from the federal government allowing Louisiana residents who receive Medicaid to qualify for long-term personal care services.

The waivers will be awarded to consumers who can demonstrate that the 32-hour cap would force them to transfer into a nursing home.

Ken Zeller, a senior AARP attorney, told the Associated Press that the settlement is “win-win” because it “allows people to age in the place they know and love and at the same time saves the state money in more costly nursing home placements.”

— by Matthew Ozga

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